Ipsilateral radial nerve, median nerve, and ulnar nerve injury caused by crush syndrome due to alcohol intoxication: A case report.

RATIONALE: Autologous peripheral nerve injury caused by crush syndrome due to alcohol intoxication is relatively rare, and to our knowledge, the compression of 3 upper limb nerves at the same time has not been reported previously. If a compressive peripheral nerve injury is not treated in a timely manner, it is difficult to recover neurological function, and the prognosis is poor. PATIENT CONCERNS: Here, we present a case of a 50-year-old man with ipsilateral radial nerve, median nerve, and ulnar nerve injuries caused by autogenous compression after drunkenness. DIAGNOSIS: Electromyography and nerve conduction studies suggested peripheral nerve injury in the left upper limb. The diagnosis was injury to the radial nerve, median nerve, and ulnar nerve in the left upper arm. INTERVENTIONS: Exploratory neurolysis surgery of the radial nerve, median nerve, and ulnar nerve was performed in the left upper arm. Postoperative oral neurotrophic drugs were administered, and functional exercise was performed. OUTCOMES: After timely diagnosis and treatment, the strength of the left upper arm muscle recovered, and the prognosis of neurological function was satisfactory during 3 years of follow-up sessions. LESSONS: In the treatment of such patients, a comprehensive understanding of their medical history and a strict physical examination should be performed. Combined with neuroelectrophysiological and imaging examination, the diagnosis can be confirmed. After timely diagnosis and treatment, the prognosis is mostly excellent.

Three-Dimensional Printing-Assisted Cervical Anterior Bilateral Pedicle Screw Fixation of Artificial Vertebral Body for Cervical Tuberculosis.

BACKGROUND: Cervical tuberculosis accounts for only 4.2%-12% of the total incidence of spinal tuberculosis cases. Although antituberculosis drugs have been the mainstay treatment of cervical tuberculosis, they have been ineffective against the symptoms of existing spinal deformities and spinal cord compression, which often require surgical intervention. The conventional surgical methods have been anterior debridement and titanium mesh, cage bone graft fusion and internal fixation. However, all have certain deficiencies regarding the stability of fixation. CASE DESCRIPTION: We have presented the case of a 41-year-old Chinese man who had been experiencing neck pain and stiffness for 1 month. The symptoms had been accompanied by low-grade fever and repeated night sweats. The purified protein derivative test result was positive and the antituberculosis test result was negative. Imaging examination showed destruction of the C5 and C6 vertebral bodies and C5 andC6 intervertebral discs, with an intensive abscess at the C5-C6 vertebral level. After 3-dimensional printing-assisted anterior debridement and artificial vertebral body replacement, his preoperative symptoms of neck pain and stiffness had been alleviated. Also, his symptoms of numbness in both upper limbs had disappeared completely. At the last follow-up examination, he had recovered well and the tuberculosis focus had been completely cured. CONCLUSION: To the best of our knowledge, we have reported the first clinical application of 3-dimensional printing-assisted cervical anterior bilateral pedicle screw fixation of an artificial vertebral body. We accomplished ultrashort segment fixation, with excellent clinical outcomes obtained, which were maintained at the recent 2-year follow-up examination.

Blockade of MMP-2 and MMP-9 inhibits corneal lymphangiogenesis.

PURPOSE: To investigate the roles of a selective MMP-2 and -9 inhibitor (SB-3CT) in corneal inflammatory lymphangiogenesis. METHODS: The expression of MMP-2 and -9 in the cornea after suture inplacement, treated with SB-3CT or negative control, was detected by real-time polymerase chain reaction (PCR). Inflammatory corneal neovascularization (NV) was induced by corneal suture placement. Mice were treated with SB-3CT eye drops (twice daily for 1 week, 5 µL per drop; 50, 100, or 200 µM). The outgrowth of blood and lymphatic vessels, and macrophage recruitment were analyzed by immunofluorescence assay. The expressions of vascular endothelial growth factor-C (VEGF-C) and its receptor VEGFR-3 were tested by real-time PCR. RESULTS: MMP-2 and -9 expression were suppressed significantly by treatment with SB-3CT. The data demonstrated, for the first time, that SB-3CT strongly reduced corneal lymphangiogenesis and macrophage infiltration during inflammation. Furthermore, expressions of VEGF-C and its receptor VEGFR-3 were significantly inhibited by SB-3CT during corneal lymphangiogenesis. CONCLUSIONS: These novel findings indicated that blockade of MMP-2 and -9 could inhibit lymphangiogenesis. Further investigation of this factor may provide novel therapies for transplant rejection and other lymphatic disorders.

[Effect of total flavonoids of astragalus on endoplasmic reticulum chaperone, calumenin and connecxin 43 in suckling mouse myocardium with myocarditis caused by coxsackievirus B3].

OBJECTIVE: To investigate the effect of total flavonoids of astragalus on the expression of endoplasmic reticulum chaperone, calumenin and connecxin 43 (CX43) in suckling mouse myocardium with myocarditis caused by coxsackievirus B3 (CVB3). METHODS: The primary culture of suckling mouse myocardium cells were randomly divided into control group, CVB3 infected group and total flavonoids of astragalus group. Firstly, to confirm the identity of the suckling mouse myocardium, α-SMA was monitored by immunohistochemistry method. Then the protein expression changes of endoplasmic reticulum chaperone-glucose regulatory protein 78 ( GRP78), calumenin and CX43 were detected by Western blot. RESULTS: (1) Compared with that of the control group, the GRP78 expression level in CVB3 infected group was improved, the expression levels of calumenin and CX43 were all reduced. (2) Compared with that of CVB3 infected group, GRP78 expression level was decreased, and the expression levels of calumenin and CX43 were increased in total flavonoids of astragalus group. CONCLUSION: CVB3 infection may cause endoplasmic reticulum stress of rat myocardium cells by increasing the expression of GRP78 and decreasing the expression of calumenin and CX43. On the other hand, total flavonoids of astragalus can reduce the expression of GRP78 and increase the expression of calumenin and CX43.The results of this experiment may be closely related to the effects of anti-arrhythmia with viral myocarditis caused by CVB3.

VEGFA Expression Is Inhibited by Arsenic Trioxide in HUVECs through the Upregulation of Ets-2 and miRNA-126.

Arsenic trioxide (ATO) has been used to treat patients with acute promyelocytic leukemia. Recently, studies have shown that ATO can induce apoptosis in leukemic cells and blood vessel endothelial cells in a time- and dose-dependent manner through the inhibition of vascular endothelial growth factor A (VEGFA) production. VEGFA is a key factor in angiogenesis initiation. Targeted inhibition of VEGF or VEGFA expression can suppress angiogenesis; however, little is known about the mechanism by which ATO inhibits VEGFA expression. In this study, we investigated the role of miRNA-126 in the mechanism of action of ATO in human umbilical vein endothelial cells (HUVECs). ATO significantly decreased the viability and proliferation of HUVECs and decreased their migration at 48 h. Cell proliferation was inhibited by 50% (IC50) when 5.0 µmol/L ATO was used. ATO treatment induced miR-126 upregulation and HUVEC apoptosis. Transfection with a miR-126 mimic significantly downregulated VEGFA mRNA levels, and transfection with a miR-126 inhibitor significantly upregulated VEGFA mRNA levels. Finally, we showed that ATO treatment upregulated Ets-2 and miR-126 expression in HUVECs. These results demonstrate that ATO inhibits the growth of HUVECs and induces apoptosis by downregulating VEGFA. One mechanism by which this occurs is Ets-2 upregulation, which results in an increase in miR-126 levels and downregulation of VEGFA expression.

[Clinical observation of acute pancreatitis treated with acupoint application combined with medicine].

OBJECTIVE: To explore a better therapeutic method for acute pancreatitis. METHODS: Sixty-three cases of acute pancreatitis were randomly divided into an observation group (31 cases) and a control group (32 cases). In the control group, routine treatment of western medicine included fasting, gastric acid and trypsinase secretion inhibition were applied, while acupoint application was added in the observation group. Yishu (Extra), Zhongwan (CV 12), Neiguan (PC 6), Zusanli (ST 36) and Pishu (BL 20) were selected as the main acupoints. The magnetic plaster was applied to the acupoints mentioned and changed once per day. Seven days made one session. RESULTS: The cured rate in the observation group was 90.3% (28/31), which was significantly higher than that of 71.9%, (23/32) in the control group (P < 0.05). The recovery time of hyper-serum amylase, hyper-uric amylase and hyper-leukocytes in the observation group was significantly shorter than that in the control group [(3.5 +/- 0.9) days vs (5.9 +/- 0.8) days, (6.1 +/- 1.5) days vs (10.5 +/- 1.8) days, (6.8 +/- 1.4) days vs (9.7 +/- 1.6) days, all P < 0.05]. The hospital stays and expenses in the observation group were significantly lower than those in the control group [(7.9 +/- 0.9) days vs (11.7 +/- 1.4) days, (5.3 +/- 1.1) thousand RMB vs (8.9 +/- 1.5) thousand RMB, both P < 0.05]. CONCLUSION: Acupoint application combined with routine treatment of western medicine is effective and can be considered as a better therapy for acute pancreatitis.

Lens proteomics: analysis of rat crystallins when lenses are exposed to dexamethasone.

To identify glucocorticoid induced cataract (GIC)-specific modified crystallins and related changes, we analyzed rat crystallins and related changes in lenses exposed to dexamethasone (Dex). To carry out proteomics analyses, we separated soluble lens proteins with two-dimensional electrophoresis (2-DE) and modified crystallins were analyzed with matrix assisted laser desorption/ionization time-of-flight tandem mass spectrometry (MALDI-TOF-MS/MS). Related changes in mRNA, protein levels and morphological and functional changes of modified crystallins were also determined. Measured masses (except for γD-crystallin as the larger and cross-link form), the isoelectric points (PIs; except for ßB3-crystallin as the alkalinization form) and amino acid sequences of all known rat crystallins matched previously reported data. Analysis by 2-DE indicated that αA, αB, ßB3 and γD increased when lenses were exposed to 5 µM Dex; ßA4 increased when lenses were exposed to 1 µM Dex and the five proteins that had the highest expressional trend were identical with the results of Q-PCR. ßA3/A1 crystallin (expressional trend identical with results of Q-PCR) and the serum albumin precursor gradually disappeared when exposed to 1-50 µM Dex. Results of Western blotting, immunohistochemistry or fluorescence analysis showed that αA and αB increased most when exposed to 5 µM Dex and ßA1/A3 and KI-67 decreased obviously when exposed to 1-50 µM Dex. Electron microscopy showed that the condition of the lens was better when lenses were exposed to 5 µM Dex than at other levels and cracks between the fiber cells became larger when lenses were exposed to 1-50 µM Dex. A chaperone role of α-crystallin protecting heated catalase (CAT) and the activity of superoxide dismutase (SOD), glutathione (GSH), and caspase-3 were highest when exposed to 5 µM Dex. Moreover, αA-crystallins were associated with increased phosphorylation (PI decreased). In conclusion, the proteomics analysis and related changes of rat crystallins when lenses were exposed to Dex in this study will be useful for comparison with normal lens proteins and GIC. We also provided a mechanism for GIC from a proteomics aspect based on the in vitro model.

Comparison of the antiangiogenic activity of modified RGDRGD-endostatin to endostatin delivered by gene transfer in vivo rabbit neovascularization model.

PURPOSE: Endostatin plays an important role in inhibiting corneal neovascularization (CNV). The aim of this study was to evaluate the antiangiogenic activities of lipid-mediated subconjunctival injection of the modified RGDRGD (arginine- glycin- aspartic- arginine- glycin- aspartic- endostatin gene in a rabbit model of neovascularization in vivo. METHODS: A modified human endostatin gene containing an RGDRGD motif was obtained by rapid site-directed mutagenesis. Forty New Zealand white rabbits underwent alkaline burn and developed CNV, which were randomly divided into four groups: an experimental control group, a PCI empty vector group, a PCI-endostatin group, and a PCI-RGDRGD-endostatin group. The vector, endostatin, and RGDRGD-endostatin groups received injections into the superior bulbar conjunctiva after the burn. An injection of 5 µg was given twice at 1-week intervals. Four eyes of two rabbits received neither treatment nor alkaline burn and served as absolute normal controls. The areas of CNV were monitored after 7 and 14 days. Corneas were examined by histology, and VEGF (vascular endothelial growth factor) and CD31 (platelet endothelial cell adhesion molecule-1) expression was detected by immunohistochemistry after 7 and 14 days. Retina, liver, and kidney were examined by histology, and CD38 expression in the inflammatory cells was detected by immunohistochemistry at 90 days. RESULTS: Subconjunctival injection of both native endostatin and modified RGDRGD-endostatin genes resulted in a significant suppression of CNV in vivo, with modified RGDRGD-endostatin being more effective than native endostatin. The mean concentration of VEGF in the PCI-RGDRGD-endostatin group significantly decreased compared to the means in the other groups. Upon histological examination, the endostatin-treated and RGDRGD-endostatin-treated eyes showed significantly less neovascular area and fewer vessels than the control and vector-injected groups. Retinal, hepatic, and renal tissue sections were normal, and there was no inflammatory cell infiltration observed. CONCLUSIONS: Native and modified endostatin can significantly inhibit CNV by suppressing the expression of VEGF. However, modified endostatin with the RGDRGD motif is far more effective than the endostatin gene in antiangiogenic activity.

[Construction of a site-directed mutant of R555W-BIGH3 and its influence on human corneal epithelial cells].

OBJECTIVE: To construct the eukaryotic express vector of wild type and R555W mutated transforming growth factor beta induced (BIGH3) gene, and to determine the effects of overexpression of R555W mutated BIGH3 in human corneal epithelial (HCE) cells. METHODS: The full coding domain sequence of BIGH3 gene was cloned from human corneal tissue from operative spackman with RT-PCR. Mutagenesis of R555W-BIGH3 was performed in rapid site-directed mutagenesis technique in the expression vector pIRES2-EGFP. The two types of BIGH3 gene were transient transfected to HCE cells. Immunoblotting was used to detect the expression of BIGH3. The cell apoptosis rates were observed by flow cytometry. The morphological changes of the cells were examined by electron microscopy. The viability of caspase-3 was examined. RESULTS: Wild type and mutated BIGH3 gene were successfully amplified by PCR. After HCE cells transfected with two types eukaryotic expression plasmid, the BIGH3 were detected in the HCE cells. The cell apoptosis were observed by flow cytometry and electron microscopy. The viability of caspase-3 was increased in the R555W mutated type. CONCLUSIONS: The R555W mutated BIGH3 is successfully obtained by rapid site-directed mutagenesis technique. Overexpression of R555W mutated BIGH3 induces apoptosis in HCE cells through activation of caspase-3.

[Effects of acupuncture on gastrointestinal responses after renal transplantation].

OBJECTIVE: To observe the effect of acupuncture on gastrointestinal responses after renal transplantation. METHODS: Sixty cases with gastrointestinal responses after renal transplantation were randomly divided into an acupuncture group and a medication group, 30 cases in each group. The acupuncture group were treated with acupuncture at Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), etc.; the medication group were treated with oral administration of Weilexin. The symptoms of abdominal pain, nausea, gastric distention, and other gastrointestinal responses were observed in the two groups. RESULTS: The effective rate was 93.3% in the acupuncture group and 76.7% in the medication group with a very significant difference between the two groups (P < 0.01), the acupuncture group being significantly better than the medication group. CONCLUSION: Acupuncture has a good effect of promoting recovery of gastrointestinal function after renal transplantation.

[Prevention and control of intestinal nematode infection in Shanghai].

OBJECTIVE: To evaluate the current status of intestinal nematode infection in Shanghai and make recommendations for further control activities. METHODS: Retrospective review of the control program was made based on the change of nematode prevalence in Shanghai area since the 1950s, and challenges under the current situation were analysed. RESULTS: The intervention measures included chemotherapy, health education, sanitary disposal of human excreta and safe water supply. With the control strategy, socio-economical development and the change of farming patterns, the prevalence of intestinal nematode infection in population was reduced by 88.5%, from 62.6% in 1955 to 8.2% in 2000. Among them, ascaris infection decreased by 89.0%, from 52.1% to 6.3%, hookworm infection decreased by 99.0%, from 12.9% to 0.1%, but pinworm infection was still as high as 18.9% in 1999. CONCLUSION: Prevalence of nematode infection in Shanghai was considerably reduced. To match it with the current socio-economical development in the Municipality, however, more needs to be done. Sustainable control activities and surveillance are recommended.